This study aims to compare plasma erythropoietin (EPO) and vascular endothelial growth factor (VEGF) levels between patients with chronic kidney disease (CKD) and cardio-renal syndrome (CRS) using enzyme-linked immunosorbent assay (ELISA). The study hypothesizes that hypoxic signaling via hypoxia-inducible factor-1 alpha (HIF-1α) is altered in CRS compared to CKD alone, affecting EPO and VEGF protein levels. Blood samples from 100 CKD patients and 100 CRS patients will be collected and analyzed to quantify and compare EPO and VEGF levels between the two groups. Correlations between the protein levels, kidney function, heart function, and